Kyle Edwards, Uehiro Centre for Practical Ethics and The Ethox Centre, University of Oxford
Caroline Huang, The Ethox Centre, University of Oxford
On November 22, in a harshly worded “warning letter,” the US Food and Drug Administration (FDA) informed the direct-to-consumer genetic testing (DTC-GT) company 23andMe that it had 15 working days to discontinue marketing of its services. By December 5, 23andMe had canceled television, radio, and online advertising and stopped selling its $99 ‘spit kit’ DNA test online.
To put it mildly, the FDA and 23andMe have some communication issues to resolve. A working relationship dating back to 2008 appears to have soured after a six-month period of silence from 23andMe, prompting the warning letter and causing many observers to comment on the apparent stupidity and mystifying nature of 23andMe’s communication ”strategy.” While the FDA’s letter is quite clear that 23andMe must communicate better, particularly in reporting the accuracy of its tests, it is not at all clear on how the FDA plans to regulate companies like 23andMe after these accuracy results are in. Moreover, it hints strongly that some tests may be banned even if they are as accurate as the tests you could receive through a physician.
Assuming 23andMe follows through on its promise to cooperate with the FDA, how exactly should these DTC-GT services be regulated to best serve the public?
In the past week in the UK, an Italian woman has claimed that a health trust had carried out a Caesarean section on her against her will. Whilst details of the case are still emerging, it appears that the woman had been detained under the Mental Health Act whilst pregnant after suffering a panic attack (which, it is reported, was possibly a result of a failure to take medication for a pre-existing mental health condition). Having been hospitalized for a number of weeks, the woman was given a Caesarean section whilst under sedation without consent. It appears that a health trust had been granted permission to carry out the procedure from the Court of Protection. Further to this, Essex social services also decreed that the mother was unfit to raise the child, and took the child into its care. Continue reading
Are we overprotective of Mars? That is the claim made by Alberto G. Fairén and Dirk Schulze-Makuch in a recent commentary in Nature Geoscience. They argue that current planetary protection policies that try to prevent bodies in the solar system from becoming contaminated by Earth-life are too costly, inhibit scientific exploration and might actually be unnecessary because of natural contamination. How much value does a pristine non-terrestrial environment have?
It’s got Nobel Prize written all over it. The scientific innovation, CRISPR, which enables accurate ‘editing’ of DNA (compared to current techniques where a viral vector introduces the DNA at random), has had one team member “jumping out of my skin with excitement”. Still at basic science level, it has already been hailed as a potential new treatment for Huntington’s Disease, HIV and other disorders. It is apparently so easy to use that Professor Mello, who was involved in the project, has said, “a total novice in my lab got it to work”.
One possible application that has been suggested is ‘correcting’ the germline: changing the genetics of sperm, eggs and embryos, to eliminate diseases not just in individuals, but in future generations. The designer baby is in production.
In a recent editorial in the British Medical Journal, Tim Kendall draws attention to a recent study that suggests that modest financial incentives can significantly improve adherence in people treated with depot drugs for schizophrenia and other psychoses in the UK. This study looks set to reignite the debate regarding the moral permissibility of offering financial incentives as a part of medical care. Whilst those who support this practice point out that we already offer non-financial rewards to many patients, others have criticised the practice as, among other things, amounting to coercion. In this post, I shall contest this particular objection to the practice of offering financial incentives to patients as part of medical care. Continue reading
In a particularly eye-catching pull quote in the November issue of The Atlantic, journalist and scholar Robert Wright claims, “The world’s gravest conflicts are not over ethical principles or disputed values but over disputed facts.”
The essay, called “Why We Fight – And Can We Stop?” in the print version and “Why Can’t We All Just Get Along? The Uncertain Biological Basis of Morality” in the online version, reviews new research by psychologists Joshua Greene and Paul Bloom on the biological foundations of our moral impulses. Focusing mainly on Greene’s newest book, Moral Tribes: Emotion, Reason, and the Gap Between Us and Them, Wright details Greene’s proposed solution to the rampant group conflict we see both domestically and internationally. Suggesting that we are evolutionarily wired to cooperate or ‘get along’ with members of groups to which we belong, Greene identifies the key cause of fighting as different groups’ “incompatible visions of what a moral society should be.” And his answer is to strive for a ‘metamorality’ – a universally shared moral perspective (he suggests utilitarianism) that would create a global in-group thus facilitating cooperation.
Last week Pieter Bonte gave a St. Cross seminar titled “Neither God nor Nature. Could the doping sinner be an exemplar of human(ist) dignity?” The talk is online as a mp3.
Here are some of my notes:
By Luke Davies
Follow Luke on Twitter.
Recently in Illinois, a woman, Colette Purifoy, has been denied a marriage license because her fiancé, John Morris, who is in a vegetative state, cannot sign the marriage form and consent (Find the story here, here, here, and here). In 2009, just before the surgery during which his anoxic brain injury was inflicted (leaving him in his current, unresponsive condition), Morris proposed to Purifoy for a second time. She said ‘Yes’, also for the second time. The couple has been together for 38 years, but hasn’t been able to marry as a result of financial and family commitments. Continue reading
“Electroceuticals”, or therapies utilising electricity, are nothing new and range from the widely accepted defibrillator/ pace makers to the more controversial electric shock therapies like ECT sometimes employed to treat severe depression.
But a recent article in Nature argues that these are just a small, crude sample of what electroceuticals may be able to offer in the future. Universities and pharmaceutical companies are researching a wide range of therapies based around electrical stimulation, promising benefits (in the long term) as diverse as mind-controlled prosthetic limbs to a treatment for anorexia. Transcranial Electric Stimulation (TES) is delivering some promising results in depression and treatment of learning disabilities.
Not only is the research potential there, but it appears that the funding is too. Nature report that GlaxoSmithKline are funding 40 researchers to pursue research in this area, amongst other initiatives to kick start electroceutical development. And earlier this year, the US invested $110 million from 2014’s budget for the “Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative”. At the same time, over in Europe, work has commenced on a 10 year, billion pound ‘Human Brain Project, bringing together 135 institutions to try to map parts of the human brain via computer simulations.
We may be starting out on the track for the “holy grail” of neuroscience: strategic control of single neuronal activity. This is, apparently, one of GSK’s goals.
With that level of control, we could finally reach the realms of science fiction: where the mind and therefore the person is under external control. Freedom might be annihilated.
We would face confronting questions over authenticity and identity. There would be alienation between the pre-existing person and their subsequent brain activity.
Burgess’ A Clockwork Orange is a graphic illustration of a common objection to enhancement, the erosion of freedom. TES at present does not appear to represent a major threat to freedom, but it is one of a family of technologies that could one day be used for effective mind control.